| NPI | 1164143905 |
|---|---|
| Other Name | SOUTHEAST ORTHOPEDIC SPECIALISTS |
| Entity Type | Organization |
| Authorized Contact | BRETT PUCKETT Authorized Official 904-634-0640 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site |
| Enumeration Date | 2022-09-09 |
| Last Update Date | 2022-09-09 |